Connecting potential XIAFLEX® patients with trained injectors

Refer your appropriate adult patients to physicians in your area who have been trained to inject XIAFLEX®*

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*Endo Pharmaceuticals Inc. maintains a list of physicians who have received the necessary training and have experience in injecting XIAFLEX® 12 or more times over the last 12 months as designated by a blue check mark. This XIAFLEX® usage information will be updated on an ongoing basis. Physicians who have received the necessary training, but have not administered at least 12 injections of XIAFLEX® over this time frame, are also listed on this website, unless they have administered <1 injection, in which case they will not be listed.

Physicians listed on this website are not affiliated with Endo Pharmaceuticals Inc., and do not pay to be on this list or to be designated as experienced users of XIAFLEX®. The Specialist Locator is a directory of physicians who have notified Endo Pharmaceuticals that they are certified in injection procedures of the hand and in the treatment of Dupuytren's contracture. Inclusion of a physician in the Specialist Locator does not constitute a referral, recommendation, endorsement, or verification of credentials, qualifications, or abilities of the physician listed. Conversely, the absence of a physician’s name and information should not be construed as a negative comment from Endo Pharmaceuticals about the physician’s credentials, qualifications, or abilities. Endo Pharmaceuticals shall not be liable for any harm resulting from your reliance on information contained in the Specialist Locator.

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Important Safety Information for XIAFLEX®

XIAFLEX® is contraindicated in patients with a history of hypersensitivity to XIAFLEX® or to collagenase used in any other therapeutic application or application method

In the controlled and uncontrolled portions of clinical trials in Dupuytren's contracture, flexor tendon ruptures occurred after XIAFLEX® injection. Injection of XIAFLEX® into collagen-containing structures such as tendons or ligaments of the hand may result in damage to those structures and possible permanent injury such as tendon rupture or ligament damage. Therefore, XIAFLEX® should be injected only into the collagen cord with a MP or PIP joint contracture, and care should be taken to avoid injecting into tendons, nerves, blood vessels, or other collagen-containing structures of the hand. When injecting a cord affecting a PIP joint of the fifth finger, the needle insertion should not be more than 2 to 3 mm in depth and avoid injecting more than 4 mm distal to the palmar digital crease

Other XIAFLEX®-associated serious local adverse reactions in the controlled and uncontrolled portions of the studies included pulley rupture, ligament injury, complex regional pain syndrome (CRPS), sensory abnormality of the hand, and skin laceration (tear). In a historically controlled post-marketing trial, the incidence of skin laceration (22%) was higher for subjects treated with two concurrent injections of XIAFLEX® compared with subjects treated with up to three single injections in the placebo-controlled premarketing trials (9%). Cases of skin laceration requiring skin graft after finger extension procedures have been reported post-marketing. Signs or symptoms that may reflect serious injury to the injected finger/hand should be promptly evaluated because surgical intervention may be required

In the controlled portions of the clinical trials in Dupuytren's contracture, a greater proportion of XIAFLEX®-treated patients (15%) compared to placebo-treated patients (1%) had mild allergic reactions (pruritus) after up to 3 injections. The incidence of XIAFLEX®-associated pruritus increased after more XIAFLEX® injections in patients with Dupuytren's contracture

Because XIAFLEX® contains foreign proteins, severe allergic reactions to XIAFLEX® can occur. Anaphylaxis was reported in a post-marketing clinical study in one patient who had previous exposure to XIAFLEX® for the treatment of Dupuytren's contracture. Healthcare providers should be prepared to address severe allergic reactions following XIAFLEX® injections

In the XIAFLEX® trials in Dupuytren's contracture, 70% and 38% of XIAFLEX®-treated patients developed an ecchymosis/contusion or an injection site hemorrhage, respectively. Patients with abnormal coagulation (except for patients taking low-dose aspirin, eg, up to 150 mg per day) were excluded from participating in these studies. Therefore, the efficacy and safety of XIAFLEX® in patients receiving anticoagulant medications (other than low-dose aspirin, eg, up to 150 mg per day) within 7 days prior to XIAFLEX® administration is not known. In addition, it is recommended to avoid use of XIAFLEX® in patients with coagulation disorders, including patients receiving concomitant anticoagulants (except for low-dose aspirin)

In the XIAFLEX® clinical trials for Dupuytren's contracture, the most common adverse reactions reported in ≥25% of patients treated with XIAFLEX® and at an incidence greater than placebo were edema peripheral (eg, swelling of the injected hand), contusion, injection site hemorrhage, injection site reaction, and pain in the injected extremity

Indication

XIAFLEX® is indicated for the treatment of adult patients with Dupuytren's contracture with a palpable cord.

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